JaypeeDigital | eBook Reader

Critical Care Narendra Rungta, Rajesh Pande, Manish Munjal, Sudhir Khunteta

SECTION 1: GENERAL
CHAPTER 1:Assessment of Critically Ill Patients
- INTRODUCTION
- OBJECTIVES
- CHANGE OF APPROACH
- FIX PHYSIOLOGY
- MONITORING: REVIEW RESPONSE
- INVESTIGATIONS: IDENTIFYING THE UNDERLYING PROBLEM
- TREATMENT: TURNING DATA INTO EFFECTIVE ACTION
  - Evidence Tidbits—Top Five Signs of Physiological Deterioration
CHAPTER 2:Airway Management in ICU
- INTRODUCTION
  - Airway Management Techniques
- ANATOMY OF AIRWAYS
  - Nerve Supply
- BASIC AIRWAY MANAGEMENT TECHNIQUES
- NONINVASIVE AIRWAY MANAGEMENT
CHAPTER 3:Hemodynamic Monitoring in ICU
- INTRODUCTION
- PHYSIOLOGICAL CONSIDERATIONS
- HEMODYNAMIC MONITORING: CLINICAL
- MONITORING INVASIVE ARTERIAL BLOOD PRESSURE
- MONITORING MARKERS OF PERFUSION (DOWNSTREAM MARKERS)
- MONITORING MICROCIRCULATION
- CHOOSING PATIENT-TAILORED HEMODYNAMIC MONITORING
- SUMMARY
CHAPTER 4:Fluid Balance in Critically III Patients
- INTRODUCTION
- SODIUM
- POTASSIUM
- CONCLUSION
CHAPTER 5:Vasopressors and Inotropes
- INTRODUCTION
- MECHANISM OF ACTION OF CATECHOLAMINES
- BASIC PRINCIPLES OF USE OF INOTROPES AND VASOPRESSORS
- PHYSIOLOGY OF INOTROPES
  - Force and Rate of Myocardial Contraction: Inotropy and Chronotropy
- PHARMACOLOGY OF INDIVIDUAL AGENTS
- DRUG CLASSIFICATION OF INOTROPES AND VASOPRESSORS
- CATECHOLAMINE VASOPRESSORS AND INOTROPES
- PHOSPHODIESTERASE INHIBITORS
  - Milrinone
- NEWER AGENTS
- CLINICAL EVIDENCE OF INOTROPES AND VASOPRESSOR USE IN DIFFERENT CLINICAL STUDY
  - Dosing and Administration in Different Clinical Trials
- INOTROPES FOR CARDIOGENIC SHOCK, CONGESTIVE HEART FAILURE AND POSTOPERATIVE SUPPORT
  - Anemia and Vasopressors Use
- CLINICAL USES HEMODYNAMIC GOALS IN SEPTIC SHOCK AND ACUTE RESPIRATORY DISTRESS SYNDROME
  - Level of Evidence According to the Surviving Sepsis Guidelines
- CONCLUSION
CHAPTER 6:Multiple Organ Dysfunction Syndrome
- INTRODUCTION
- DEFINITION
- MECHANISMS OF MULTIPLE ORGAN DYSFUNCTION SYNDROME
- PATHOGENESIS
- GUT HYPOTHESIS
- MANAGEMENT OF MULTIPLE ORGAN DYSFUNCTION SYNDROME/MULTIPLE ORGAN FAILURE
- PREVENTION OF MULTIPLE ORGAN DYSFUNCTION SYNDROME
- PROGNOSIS
- CONCLUSION
CHAPTER 7:Cardiopulmonary Resuscitation: A Paradigm Shift
- CARDIAC ARREST
- CARDIOPULMONARY RESUSCITATION
- HISTORY OF CPR
- EPIDEMIOLOGY
- BASIC LIFE SUPPORT
- Key Changes and Highlights of 2010 AHA Guidelines
- CHAIN OF SURVIVAL
  - Hands-Only CPR or Cardio Cerebral Resuscitation (CCR)
    - Advantages
    - Limitations
- ADVANCED CARDIAC LIFE SUPPORT
  - Key Issues and Major Changes
- CONCLUSION
CHAPTER 8:Therapeutic Hypothermia
- INTRODUCTION
  - Patient Selection
- INDUCTION PHASE
  - External Cooling
  - Internal Cooling
- MAINTENANCE PHASE
- REWARMING PHASE
  - Adverse Effects of Therapeutic Hypothermia
CHAPTER 9:Management of Organ Donor
- INTRODUCTION
- WHEN TO TEST FOR BRAIN-DEATH?
- TESTS OF BRAINSTEM DEATH
- CLASSIFICATION OF ORGAN DONORS
- DIFFERENT LEVELS OF CARE REQUIRED IN BRAIN-DEAD PATIENTS
  - Incidence of Changes After Brain Death
- PRINCIPLES OF DONOR MANAGEMENT
- ORGAN DONOR MANAGEMENT
- OTHER ISSUES IN BRAIN-DEAD PATIENTS
CHAPTER 10:Scoring Systems in ICU
- SCORING SYSTEMS IN ICU
- DIFFERENT ICU SCORING SYSTEMS
- EVOLUTION OF DIFFERENT SCORING SYSTEMS
- COMPARISON BETWEEN MODELS (APACHE VS MPM VS SAPS)
- STEPS INVOLVED IN DEVELOPING A SCORING SYSTEM MODEL
- PRACTICAL USE OF APACHE IV IN A MULTIDISCIPLINARY ICU TO EVALUATE OUTCOME
- PITFALLS IN APPLICATION OF SCORING SYSTEMS
- CONCLUSION
CHAPTER 11:Guidelines for ICU Planning and Designing in India
- INTRODUCTION
  - Need for a New ICU/Renovation of the Old One
- GOAL
  - ICU Planning
- CRITICAL CARE UNIT (CCU)— FUNCTIONAL MODEL
- CLINICAL SUPPORT ZONE
- UNIT SUPPORT ZONE
- FAMILY SUPPORT ZONE
- HIGH DEPENDENCY UNIT
- SUMMARY
CHAPTER 12:Guidelines and Protocols in ICU
- INTRODUCTION
- HISTORICAL BACKGROUND OF CLINICAL PRACTICE AND GUIDELINES
- DEFINING TERM
  - Guidelines
  - Protocols
- GUIDELINES AND PROTOCOLS AVAILABLE IN INTENSIVE CARE FOR HEALTHCARE PROFESSIONALS
- CONCLUSION
CHAPTER 13:Clinical Audit and Handoff in ICU
- CLINICAL AUDIT IN ICU
- HANDOFF IN ICU
CHAPTER 14:Critical Care Nursing in India
- INTRODUCTION
- QUALITY OF EDUCATION
  - Distance Education
  - Foreign Exchange Program
- HUMAN RESOURCES AND NURSING
SECTION 2: CARDIAC CARE
CHAPTER 15:Acute Coronary Syndrome
- DEFINITION
- CLINICAL CLASSIFICATION OF MYOCARDIAL INFARCTION
- PATHOPHYSIOLOGY
- DIAGNOSIS
- RISK STRATIFICATION
- MANAGEMENT
CHAPTER 16:Heart Failure
- INTRODUCTION
- DEFINITION OF HEART FAILURE
  - Definition of Acute Decompensated Heart Failure
  - Heart Failure with Reduced Ejection Fraction
  - Heart Failure with Preserved Ejection Fraction
- ETIOLOGY
- FUNCTIONAL CLASSIFICATION OF HEART FAILURE
- New York Heart Association Classification
- ACC/AHA Stage of Heart Failure
- PATHOPHYSIOLOGY OF HEART FAILURE
- DIAGNOSIS
  - History and Physical Examination
  - Cardiovascular Examination
  - Respiratory Examination
  - Abdominal Examination
  - General Physical Examination
- INVESTIGATIONS
- Electrocardiogram
- Chest Radiography
- Echocardiography
- B-type Natriuretic Peptides
- Cardiac Causes
- Noncardiac Causes
- Biomarker of Myocardial Injury Troponin T or I
- INVASIVE EVALUATION
- PRECIPITATING FACTORS FOR ADHF
- TREATMENT OF ADHF
  - Oxygen
  - Morphine
  - Diuretics
  - Vasodilators
  - Nitroglycerin
  - Nesiritide
  - Nitroprusside
  - Inotropic Agents
  - Dopamine
  - Dobutamine
  - Milrinone
  - Levosimendan
  - Vasopressin Antagonist
  - Neurohormonal Blockade
  - Beta-blocker
  - Angiotensin-Converting Enzyme Inhibitors
  - Aldosterone Antagonists
  - Ultrafiltration
  - Management of Atrial Fibrillation in Heart Failure Patients
- ANEMIA
- MECHANICAL CIRCULATORY DEVICES
  - Intra-Aortic Balloon Pump Counter-pulsation
  - Complications
  - Extra Corporeal Membrane Oxygenation
- VENTRICULAR ASSIST DEVICES
- TandemHeart
- Contraindications of TandemHeart Device
- Complication of TandemHeart Device
- Impella Recover
- Contraindications
- Complications
- Continuous Aortic Flow Augmentation
- Implantable Cardioverter-Defibrillator
- CARDIAC RESYNCHRONIZATION THERAPY
- DISCHARGE PLANNING AND OUTPATIENT CARE
- SUMMARY
CHAPTER 17:Cardiac Arrhythmias in ICU
- OBJECTIVES
- INTRODUCTION
- NORMAL ECG WAVES AND INTERVALS
- NORMAL SINUS RHYTHM (FIG. 2)
  - Mechanisms of Tachyarrhythmias
- SUPRAVENTRICULAR TACHYARRHYTHMIAS
  - Diagnosis
- SINUS TACHYCARDIA
  - ECG Features (Fig. 3)
  - Treatment
- ATRIAL FIBRILLATION
- ATRIAL FLUTTER
  - ECG Features (Fig. 5)
  - Management
- PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA
- MULTIFOCAL ATRIAL TACHYCARDIA
  - ECG Features (Fig. 8)
  - Management
- VENTRICULAR TACHYARRHYTHMIAS
CHAPTER 18:Hypertensive Emergency
- INTRODUCTION
- DEFINITION
- Accelerated Hypertension
- Malignant Hypertension
- Hypertensive Urgency
- Hypertensive Emergency
- PATHOPHYSIOLOGY
- DIAGNOSIS OF HYPERTENSIVE EMERGENCY
- TREATMENT OF HYPERTENSIVE EMERGENCY
- PHARMACOLOGIC AGENTS FOR TREATMENT OF HYPERTENSIVE EMERGENCY
- SPECIAL CONDITIONS
- CONCLUSION
CHAPTER 19:Pacing in the ICU Setting
- HISTORICAL PERSPECTIVES
- INDICATIONS
  - Bradycardias
  - Tachycardias
- PROCEDURAL DETAILS
  - Equipment
  - Procedural Characteristics
- COMPLICATIONS
  - Local Site Complications
  - Complications of Lead Placement
- EMERGENCY TRANSCUTANEOUS PACING
CHAPTER 20:Pulmonary Embolism
- INTRODUCTION
- PATHOPHYSIOLOGY
- CLINICAL FEATURES
- INITIAL RESUSCITATION
- DIFFERENTIAL DIAGNOSIS
- ASSESS CLINICAL PROBABILITY OF PULMONARY EMBOLISM
- MASSIVE PULMONARY EMBOLISM
- SUBMASSIVE PULMONARY EMBOLISM
- LOW RISK PULMONARY EMBOLISM
- TREATMENT
  - Empiric Anticoagulation
- INVESTIGATIONS
- THROMBOLYTIC THERAPY PROTOCOL
- IVC Filters
- Embolectomy
- Catheter Embolectomy
- Surgical Embolectomy
- SUMMARY AND RECOMMENDATIONS
CHAPTER 21:Intensive Care Unit Management of Patients with Right Heart Failure
- INTRODUCTION
- DEFINITION
- ETIOLOGY AND PATHOPHYSIOLOGY OF RIGHT VENTRICULAR FAILURE
- Factors Affecting Right Ventricular Function in ICU
- Monitoring of Right Ventricular Function in the ICU
- Pulmonary Artery Catheterization (PAC)
- Echocardiography
- Cardiac Magnetic Resonance Imaging
- Biomarkers
- TREATMENT OF RIGHT VENTRICULAR FAILURE
- General Supportive ICU Care
- Strategies to Improve Right Ventricular Function (Flowchart 2)
SECTION 3: RESPIRATORY CARE
CHAPTER 22:Community Acquired Pneumonia
- INTRODUCTION
- EPIDEMIOLOGY
- PATHOGENESIS OF CAP
CHAPTER 23:Ventilator-Associated Pneumonia
- INTRODUCTION
- HEALTHCARE-ASSOCIATED PNEUMONIA
- EPIDEMIOLOGY OF VAP
- CLINICAL PRESENTATION OF VAP
  - Patient History
  - Diagnostic Triad
- RISK FACTORS FOR VAP
CHAPTER 24:Acute Respiratory Distress Syndrome
- INTRODUCTION
- DEFINITIONS OF ARDS
- CLINICAL DISORDERS ASSOCIATED WITH ARDS
- PATHOPHYSIOLOGY
- The Acute or Exudative Phase
- Intermediate Phase
- Resolution
- Baby Lung Concept
- Characteristics of a Baby Lung
- EFFECT OF POSITIVE PRESSURE VENTILATION IN ARDS LUNGS
- VENTILATORY STRATEGIES IN ARDS
- Open Lung
- Landmark ARDS net Study
- High versus Low PEEP
- Ventilator Procedures
SECTION 4: LIVER AND DIGESTIVE SYSTEM
CHAPTER 25:Acute Liver Failure
- INTRODUCTION
- DEFINITION
- Etiology
- Viral Infections
- Drug-induced Injury
- Pathogenesis of Acute Liver Failure
- Clinical Management
- Initial Evaluation and Case Specific Management
- Other Causes of ALF
- ICU Management of ALF
- Outline of ICU Management
- Management of Intracranial Hypertension
- Intracranial Hypertension: General Management Principles
- Role of ICP Monitoring
- Management of Hemodynamics
- Management of Coagulopathy
- Renal Failure Management
- Infectious Disease Considerations
- Nutrition
- Prediction for Spontaneous Recovery
- Liver Support Devices
- LIVER TRANSPLANTATION
- Future Direction
- CONCLUSION
CHAPTER 26:Acute Pancreatitis
- INTRODUCTION
- ETIOLOGY
- EPIDEMIOLOGY
- ASSESSMENT OF SEVERITY
- DEFINING THE SEVERITY
- HISTORY
- PHYSICAL EXAMINATION
- DIAGNOSIS
- Some Important Comments
- TREATMENT
- Fluid Resuscitation
- Nutritional Support
- ANTIBIOTIC PROPHYLAXIS
- Sterile Necrosis
- Infected Necrosis
- ERCP IN ACUTE PANCREATITIS
- CHOLECYSTECTOMY
CHAPTER 27:Hepatorenal and Hepatopulmonary Syndromes
- HEPATORENAL SYNDROME
- DEFINITION
- Classif ication of the Cirrhotics
- A Classical Case Presentation
- HEPATORENAL SYNDROME
- Clinical Types of Hepatorenal Syndrome
- Epidemiology
- Differential Diagnosis
- Diagnostic Criteria
- DEFINITION
- PATHOPHYSIOLOGY
- Hypoxemia
- Clinical Manifestations
- DIAGNOSIS
- Diagnostic Procedures
- TREATMENT
  - Medical Therapy
  - Interventions other Than Liver Transplantation
CHAPTER 28:Anesthesia for Liver Transplantation
- INTRODUCTION
- ANESTHETIC MANAGEMENT OF DONOR
CHAPTER 29:Critical Care Aspects in Adult Liver Transplantation
- INTRODUCTION
- FUNCTION OF THE LIVER ALLOGRAFT
- SYSTEMIC MANAGEMENT
SECTION 5: RENAL CARE
CHAPTER 30:Diagnosis of Acute Kidney Injury
- INTRODUCTION
- LABORATORY ASSESSMENT OF RENAL FUNCTION
- RADIOLOGIC STUDIES
- RENAL BIOPSY
CHAPTER 31:Renal Replacement Therapy
- INTRODUCTION
- INDICATIONS
- PRINCIPLES OF RENAL REPLACEMENT THERAPY
CHAPTER 32:Critical Care Management of Renal Transplant Recipients
- INTRODUCTION
- HEMODYNAMIC STABILITY
- INFECTION PROPHYLAXIS
- GRAFT FUNCTION
- IMMUNOSUPPRESSANTS
- CARDIOVASCULAR STABILITY
- OTHER SUPPORTIVE CARE
CHAPTER 33:Acid-Base Disorders in Critical Care
- INTRODUCTION
- PHYSIOLOGY OF ACID-BASE HOMEOSTASIS
- ANALYSIS OF DISORDERS OF ACID-BASE BALANCE
- HOW DO YOU DIAGNOSE ACID-BASE DISORDERS?
  - METABOLIC ACIDOSIS
CHAPTER 34:Disorders of Potassium
- PATHOPHYSIOLOGY OF POTASSIUM
- HYPOKALEMIA
- Causes of Hypokalemia
- Clinical Manifestations of Hypokalemia
- Diagnosis of Hypokalemia
- Treatment of Hypokalemia
- Potassium Deficit
- Potassium Preparations
- Mild-to-Moderate Potassium Depletion
- Severe Hypokalemia
- HYPERKALEMIA
- Etiology
- Causes of Hyperkalemia
CHAPTER 35:Sodium Disorders
- HYPERNATREMIA
- CONCLUSION
- INTRODUCTION
- Relationship between Plasma Na+ and Plasma Osmolality
- Regulation of P-[Na+ ]/Regulation of Plasma Osmolality
- CLASSIFICATION
CHAPTER 36:Disorders of Calcium and Magnesium
- INTRODUCTION
- CALCIUM METABOLISM
- DISORDERS OF CALCIUM METABOLISM
- MAGNESIUM METABOLISM
- DISORDERS OF MAGNESIUM METABOLISM
SECTION 6: NEUROLOGICAL CARE
CHAPTER 37:Management of Critically Ill Trauma Patients
- INTRODUCTION
- GENERIC APPROACH TO TRAUMA CARE
- PREPARATION
- TRIAGE
- PRIMARY SURVEY
- Airway with Cervical Spine Control
- Breathing and Ventilation
- Circulation with Hemorrhage Control
- Disability
- Exposure and Environmental Control
- Adjuncts to Primary Survey and Resuscitation
- SECONDARY SURVEY
- TERTIARY ASSESSMENT AND ONGOING PHYSIOLOGIC SYSTEM CONTROL
- Respiratory Control
- Circulatory Control
- Nervous System Control
- Monitoring ICP
- Care of Postoperative Neurotrauma Patient
- Analgesia and Sedation
- Metabolic Control
- Nutrition
- Host Defense
- Abdominal Problems
- Musculoskeletal Trauma
- REHABILITATION
- BRAIN DEATH AND ORGAN DONATION
- SUMMARY
CHAPTER 38:Management of Spinal Injury
- INTRODUCTION
- ETIOLOGY
- PATHOGENESIS
- Primary Injury
- Secondary Injury
- CLINICAL FEATURES
- Neurological Assessment
- Associated Injuries
- IMAGING
- CLEARANCE OF CERVICAL SPINE
- MANAGEMENT
CHAPTER 39:Neurocritical Care Management of Subarachnoid Hemorrhage
- INTRODUCTION
- Clinical Presentation
- Diagnosis
- Neuromonitoring in SAH
  - Management of SAH and Its Complications
CHAPTER 40:Intensive Care Management of Postoperative Neurosurgical Patients
- INTRODUCTION
- LOCATION AND DURATION OF POSTOPERATIVE NEUROCRITICAL CARE
- POSTOPERATIVE ANESTHESIA CONSIDERATIONS
- GOALS OF POSTOPERATIVE NEUROSURGICAL CARE
- PREVENTION AND MANAGEMENT OF SYSTEMIC COMPLICATIONS AFTER NEUROSURGERY
- Cardiac Dysfunction
- Neurogenic Pulmonary Edema
- Hypercoagulopathy and Thrombosis Prophylaxis
- PREVENTION AND MANAGEMENT OF POSTOPERATIVE NEUROSURGICAL COMPLICATIONS
- Postoperative Brain Swelling
- Postoperative Intracranial Hematoma
- Hydrocephalus
- Seizures
- Tension Pneumocephalus
- MONITORING DURING THE POSTOPERATIVE PERIOD
- Respiratory Monitoring
- Cardiovascular System
- Neurological Monitoring
- Temperature Monitoring
- Intracranial Pressure Monitoring and Cerebral Perfusion Pressure
- Cerebral Blood Flow Monitoring
- Cerebral Oxygenation and Metabolism
- Microdialysis
- Electroencephalogram (EEG) Monitoring
- POSITIONING OF THE PATIENT IN THE POSTOPERATIVE PERIOD
- POSTOPERATIVE ANALGESIA
- POSTOPERATIVE FLUID MANAGEMENT
- NEUROSURGICAL INTENSIVE CARE UNIT DISCHARGE CRITERIA
- CONCLUSION
SECTION 7: OBSTETRIC CRITICAL CARE
CHAPTER 41:Physiology of Pregnancy
- INTRODUCTION
- PHYSIOLOGICAL CHANGES DURING PREGNANCY AND ITS RELEVANCE IN ICU CARE OF OBSTETRIC PATIENTS
- RESPIRATORY CHANGES
- CARDIAC CHANGES
- RENAL CHANGES
- FETAL PHYSIOLOGY
  - Maternal Fetal Circulation
- ACID-BASE STATUS
- PLACENTAL GAS EXCHANGE
- RADIOLOGIC PROCEDURES AND FETAL RISK
- DRUG THERAPY
CHAPTER 42:Respiratory Disorders During Pregnancy
- INTRODUCTION
- ASTHMA
- Effect on Pregnancy
- Management
- ACUTE RESPIRATORY DISTRESS SYNDROME
- Nonventilatory Strategies
- Pulmonary Hypertension
CHAPTER 43:Liver Disease Complicating Pregnancy
- INTRODUCTION
CHAPTER 44:Peripartum and Postpartum Intensive Care in Pregnancy
- INTRODUCTION
- PERIPARTUM ISSUES AND ANESTHETIC CONSIDERATIONS
SECTION 8: PEDIATRIC CRITICAL CARE
CHAPTER 45:Recognition and Assessment of Critically Ill Child
- INTRODUCTION
- Evaluate, Identify and Intervene
- INITIAL IMPRESSION
- Consciousness
- Work of Breathing
- Circulation to Skin
- PRIMARY ASSESSMENT
- A: Airway
- B: Breathing
- Intervention
- C: Circulation
- D: Disability (Mental Status)
- E: Exposure
- SECONDARY ASSESSMENT
- ONGOING ASSESSMENT
- Categorization by Severity— Respiratory Distress
- Respiratory Failure
- Categorization by Severity
- Hypotensive
- Initial Stabilization
- Common Initial Interventions
- Foreign Body Obstruction
  - If known Foreign Body Obstruction
  - Monitor Oxygen Saturation If Pulse Oximeter is Available
CHAPTER 46:Pediatric Septic Shock
- INTRODUCTION
- PATHOPHYSIOLOGY
- CLINICAL PROGRESSION OF SEPTIC SHOCK
- IMMUNITY IN SEPTIC SHOCK
- DEFINITIONS AND SEVERITY OF SEPSIS
- EARLY RECOGNITION OF SEPTIC SHOCK
- LABORATORY TESTING
- MONITORING PARAMETERS IN PEDIATRIC SEPTIC SHOCK
- MANAGEMENT OF SHOCK
- Airway and Oxygen
- Intravenous Access
- Fluid Resuscitation
- Cardiovascular Support
- End-Points
- MULTI-PRONGED SEPSIS CONTROL STRATEGY
- CATECHOLAMINE REFRACTORY SHOCK
- PROGNOSIS AND OUTCOME OF SEPTIC SHOCK
- FUTURE DIRECTIONS
CHAPTER 47:Status Epilepticus
- DEFINITION
- CLASSIFICATION
- ETIOLOGY
- PATHOPHYSIOLOGY
- DIAGNOSIS
- TREATMENT OF STATUS EPILEPTICUS
- INITIAL STABILIZATION
- Airway
- Breathing
- Circulation
- Disability
- EVALUATION
- History
- Physical Examination
- TERMINATION OF SEIZURES
- Step 1
- Step 2
- Step 3
- Intravenous Levetiracetam
- Step 4
- Benzodiazepine Infusion
- Barbiturates
- Propofol
- Ketamine
- Lidocaine
- Inhalational Anesthetics
- Other Treatment Options
  - Pyridoxine Infusion
  - Immunotherapy
  - Resective Neurosurgery
  - Ketogenic Diet
  - Other Options
  - OUTCOME
CHAPTER 48:Raised Intracranial Pressure in Children with an Acute Brain Injury: Monitoring and Management
- INTRODUCTION
- CEREBRAL PHYSIOLOGY AND INTRACRANIAL DYNAMICS
SECTION 9: INFECTIONS
CHAPTER 49:Extended Spectrum Beta Lactam Producing Infections in Intensive Care Unit
- INTRODUCTION
- ESBL CLASSIFICATION
- TYPES OF ESBL
- ESBL IS A GLOBAL PROBLEM
CHAPTER 50:Infections in Immunocompromised Patients in ICU
- INTRODUCTION
- PATHOGENESIS
- DIABETIC PATIENTS WITH LIFE-THREATENING INFECTIONS
- COPD PATIENTS WITH LIFE-THREATENING INFECTIONS
- CKD PATIENT WITH LIFE-THREATENING INFECTIONS
- CIRRHOTIC PATIENTS WITH LIFE-THREATENING INFECTIONS
- HEART FAILURE PATIENTS WITH LIFE-THREATENING INFECTIONS
- SUMMARY
CHAPTER 51:Invasive Fungal Infections in Critically Ill Patients
- INTRODUCTION
- EPIDEMIOLOGY
- Candida Albicans
- Candida Glabrata
- Candida Parapsilosis
- Candida Tropicalis
- Candida Krusei
- Aspergillosis
- PATHOGENESIS
CHAPTER 52:Febrile Neutropenia
- INTRODUCTION
- AN ILLUSTRATIVE CASE
- DEFINITION OF FEBRILE NEUTROPENIA
- Common Causative Bacterial Pathogens Implicated in Febrile Neutropenia
- MANAGEMENT OF FEBRILE NEUTROPENIA
CHAPTER 53:Fever in the ICU
- INTRODUCTION
- DEFINITIONS
- PHYSIOLOGY
- BENEFICIAL EFFECTS OF FEVER
- DELETERIOUS EFFECTS OF FEVER
- NONINFECTIOUS CAUSES OF FEVER
- OTHER NONINFECTIOUS CAUSES OF FEVER
- INFECTIOUS CAUSES OF FEVER
- DRUG FEVERS
- POSTOPERATIVE FEVER
- APPROACH TO FEVER IN ICU
- NEW FEVER IN ICU
- RECOMMENDATIONS FOR MEASURING TEMPERATURE
- RECOMMENDATIONS FOR OBTAINING BLOOD CULTURES
- Recommendations for Management of Intravascular Catheters
- RECOMMENDATIONS FOR EVALUATION OF PULMONARY INFECTIONS
- IF PNEUMONIA IS DOCUMENTED
- RECOMMENDATIONS FOR CULTURES IN PULMONARY INFECTIONS
- Recommendations for Evaluation of Gastrointestinal Tract Stool Evaluation in Febrile ICU Patient
- RECOMMENDATIONS FOR EVALUATION OF THE URINARY TRACT
- RECOMMENDATIONS FOR EVALUATION OF CENTRAL NERVOUS SYSTEM
- RECOMMENDATIONS FOR EVALUATION OF THE SINUSES
- RECOMMENDATIONS FOR EVALUATION OF FEVER WITHIN 72 HOURS OF SURGERY
- RECOMMENDATIONS FOR EVALUATION OF SURGICAL SITE INFECTION
- RECOMMENDATIONS FOR USING BIOMARKERS TO DETERMINE THE CAUSE OF FEVER
CHAPTER 54:Cytomegalovirus Infection in Critically Ill Patients
- INTRODUCTION
- RISK FACTORS
- PATHOPHYSIOLOGY
- DIAGNOSIS
- MANAGEMENT
CHAPTER 55:Tropical Infections in ICU
- INTRODUCTION
- FEVER WITH THROMBOCYTOPENIA
- FEVER WITH PULMONARY DYSFUNCTION
- FEVER WITH HEPATORENAL DYSFUNCTION
- FEVER WITH CENTRAL NERVOUS SYSTEM INVOLVEMENT
- FEVER WITH SHOCK
- MANAGEMENT OF SPECIFIC INFECTIONS IN ICU
- Scrub Typhus
- Complications
- Diagnosis
- Treatment
- CONCLUSION
CHAPTER 56:Tropical Fever— Management Guidelines ISCCM Tropical Fever Group
- Undifferentiated Fever
- Fever with Rash/Thrombocytopenia
- Fever with Acute Respiratory Distress Syndrome (ARDS)
- Febrile Encephalopathy
- Fever with Multiorgan Dysfunction
- MANAGEMENT
- SPECIFIC INFECTIONS
- SCRUB TYPHUS
- Lab Diagnosis (Serology)14
- Treatment15,16
- LEPTOSPIROSIS
- Biphasic Clinical Presentation
SECTION 10: ETHICS AND END-OF-LIFE CARE ISSUES
CHAPTER 57:Bioethical Considerations
- INTRODUCTION
- ROLE OF ETHICS COMMITTEE
- COMMUNICATION
CHAPTER 58:End-of-Life Care Practices in the World
- INTRODUCTION
SECTION 11: MISCELLANEOUS
CHAPTER 59:Burns, Inhalation and Electrical Injury
- INTRODUCTION
- PREVALENCE
- CAUSES
- INCIDENCE OF BURNS
- Young Children
- Older Children and Adolescents
- Working Age
- Elderly People
- Compromising Factors
- AIMS OF BURN CARE
- PATHOPHYSIOLOGY
- INFECTION IN BURNS PATIENTS
- PATHOGENESIS
  - Preventing Invasive Wound Infection
  - Diagnosing Invasive Wound Infection
- TREATMENT
- Infection Control
- BURNS IN THE DEVELOPING WORLD AND BURN DISASTERS
- FURTHER TREATMENT
CHAPTER 60:Diabetic Ketoacidosis
- ETIOPATHOGENESIS
- DIAGNOSIS
- Clinically
- Blood
- Urine
- DIFFERENTIAL DIAGNOSIS
- MANAGEMENT
CHAPTER 61:Oncological Emergencies
- INTRODUCTION
- TUMOR LYSIS SYNDROME
- Conditions Associated with Tumor Lysis Syndrome
- Risk Factors for Tumor Lysis Syndrome
- Pathophysiology of Tumor Lysis Syndrome
- Pathophysiology of Acute Renal Failure
- Diagnosis of Tumor Lysis Syndrome
- Monitoring Parameters
- Treatment of Tumor Lysis Syndrome
- Hydration
- Antihyperuricemic Therapy
- Other Supportive Therapies
- HYPERCALCEMIA
- Etiopathogenesis
- Diagnosis
- Grading Hypercalcemia of Malignancy
- Treatment
- Treatment Principles
- Advice on Discharge
- SUPERIOR VENA CAVA SYNDROME
- Causes of SVC Syndrome
- Clinical Features
- Investigations
  - Imaging
  - Tissue Diagnosis
  - Treatment
  - Stents
  - SPINAL CORD COMPRESSION
  - BRAIN METASTASES AND INCREASED INTRACRANIAL PRESSURE
  - HYPERVISCOSITY SYNDROME
  - Etiopathogenesis
  - Diagnosis
  - Treatment
  - Hyperleukocytosis and Leukostasis
  - MALIGNANT PERICARDIAL EFFUSION
  - Signs and Symptoms
  - Diagnosis
  - Treatment
  - AIRWAY OBSTRUCTION
  - Signs and Symptoms
  - Diagnosis
  - Treatment
  - Radiation Therapy
CHAPTER 62:Post-cardiac Arrest Syndrome
- INTRODUCTION
- PATHOPHYSIOLOGY
- PERSISTENT PRECIPITATING PATHOLOGY
- PHASES OF RESUSCITATION SYNDROME
- THERAPEUTIC STRATEGIES
- MONITORING
- ORGAN-SPECIFIC EVALUATION AND SUPPORT
  - Cardiovascular System: Early Hemodynamic Optimization
  - Antiarrhythmic Drugs
- NEUROPROTECTIVE STRATEGIES
- THERAPEUTIC HYPOTHERMIA
- PROGNOSTIC FACTORS
- ADJUNCTIVE INVESTIGATIONS
- ETHICS
- SUMMARY
CHAPTER 63:Intra-abdominal Hypertension and Abdominal Compartment Syndrome
- INTRA-ABDOMINAL HYPERTENSION AND ABDOMINAL COMPARTMENT SYNDROME
CHAPTER 64:Nutrition in a Critically Ill Patients
- INTRODUCTION
- NUTRITIONAL ASSESSMENT IN THE CRITICALLY ILL
- GENERAL STRATEGY FOR ICU PATIENTS
- Enteral Nutrition
- Parenteral Nutrition
- Immunonutrition
- L-Arginine
- Omega-3 Fatty Acids
- Selenium
- CONCLUSION
CHAPTER 65:Approach to an Unknown Poisoning
- INTRODUCTION
- DIAGNOSIS
- History
- Examination
- Identification of Toxidromes
- Lab Investigations
- MANAGEMENT
- COMA COCKTAIL
- REMOVAL OF POISON
- Decontamination
- Enhanced Elimination
- Antidotes
CHAPTER 66:Specif ic Intoxicatio ns
- ACETAMINOPHEN
- Clinical Features
- Diagnostic Evaluation
- Treatment
- AMPHETAMINE AND COCAINE
- Diagnostic Evaluation
- Treatment
- ALUMINUM AND ZINC PHOSPHIDE
- Management
- CARBON MONOXIDE (CO) POISONING
- Pathophysiology
- Clinical Features
- Diagnostic Evaluation
- Treatment
- INSECTICIDE POISONING (ORGANOPHOSPHATES, CARBAMATE, ORGANOCHLORINE, HERBICIDE)
- Organophosphate Poisoning
- Clinical Features
- Diagnostic Evaluation
- Treatment of Organophosphate Poisoning (OP)
- Specific Therapy
- Carbamate Poisoning
- Treatment
- Organochlorine Poisoning
- Mechanism of Action
- Clinical Features
- Diagnostic Evaluation
- Treatment
- BIPYRIDYL COMPOUND
- Treatment
- OPIOIDS
- Clinical Features
- Treatment
- ALCOHOL POISONING
- ETHANOL POISONING
- Diagnostic Evaluation
- Treatment
- METHANOL POISONING
- Clinical Features
- Diagnostic Evaluation
- Treatment
- DETERGENT POISONING
CHAPTER 67:Fatal Envenomations
- INTRODUCTION
- SNAKEBITE
CHAPTER 68:Care of Obese Patient in ICU
- INTRODUCTION
- DEFINITION AND CLASSIFICATION OF OBESITY
- Extent of Problem
- Airway
- Mechanical Ventilation
- Pharmacokinetics
- Hematology
- Nutrition
- OBESITY PARADOX
- CONCLUSION
CHAPTER 69:Imaging in Intensive Care Unit
- INTRODUCTION
  - Chest Imaging
    - Role of Radiograph
    - Role of Ultrasonography
  - Abdominal Imaging
SECTION 12: MECHANICAL VENTILATION
CHAPTER 70:Respiratory Mechanics: Basics
- INTRODUCTION
- Peak Airway Pressure
- Plateau Pressure
- Intrinsic Positive End Expiratory Pressure
- LUNG CHARACTERISTICS
CHAPTER 71:Principles of Mechanical Ventilation
- ACUTE RESPIRATORY FAILURE
- TARGETS OF VENTILATION
- POSITIVE PRESSURE VENTILATION
CHAPTER 72:Basic Modes of Ventilation
- INTRODUCTION
- Volume-Control Mode
- Pressure Control Mode
- SIMV mode (Synchronized Intermittent Mandatory Ventilation)
- Pressure Support Mode
- CPAP Mode
CHAPTER 73:Ventilator Graphics
- INTRODUCTION
- VENTILATOR WAVEFORMS
- Pressure-Time Waveform
- Flow-Time Waveforms
- WAVEFORMS IN DIFFERENT MODES OF VENTILATION
- Finding Autopeep with Graphics
- Understanding Ventilator Loops
- The Inflection Points Using Loops
- Abnormal PV Loops in Clinical Practice
- CONCLUSION
CHAPTER 74:Newer Modes of Ventilation
- INTRODUCTION
- AIRWAY PRESSURE RELEASE VENTILATION
- Application of Airway Pressure Release Ventilation
- Adjustments
- High Mean Airway Pressure
- Bi-level Mode
- Using Pressure Support with Bi-level Mode of Ventilation
- Automatic Tube Compensation
- PROPORTIONAL ASSIST VENTILATION
- NEURALLY ADJUSTED VENTILATORY ASSIST
CHAPTER 75:Weaning/Liberation from Mechanical Ventilation
- INTRODUCTION
- FACTORS AFFECTING WEANING
- CONSIDERATIONS FOR ASSESSING READINESS TO WEAN
- TWO-STAGE APPROACH TO WEANING
- ROLE OF NONINVASIVE VENTILATION IN WEANING
- APPLICATIONS OF NONINVASIVE VENTILATION
- SUMMARY
CHAPTER 76:Non-Invasive Ventilation
- INTRODUCTION
- ADVANTAGES OF NIV
- DIFFERENT TYPES
- HOW DOES NIV WORK?
- INDICATIONS OF NIV
- DETERMINANTS OF NIV SUCCESS IN COPD PATIENTS
- NON-INVASIVE VENTILATION FAILURE
- EMERGING MODES OF NON-INVASIVE VENTILATION
CHAPTER 77:Ventilation Strategy in Obstructive Airway Disease
- INTRODUCTION
- PATHOPHYSIOLOGY
- VENTILATION IN ASTHMA
CHAPTER 78:Ventilation Strategy in Trauma
- INTRODUCTION
- TRAUMATIC BRAIN INJURY
- Intracranial Pressure
- Cerebral Perfusion Pressure and Cerebral Blood Flow
- Intubation in TBI
- Intubation in TBI
- Ventilation in TBI
- CHEST TRAUMA
- Independent Lung Ventilation
- Recommendations of use of ILV
- Independent Lung Ventilation
- Clinical Scenarios and their Management
- SUMMARY
CHAPTER 79:Rescue Strategies in ARDS—Recruitment Maneuvers
- RECRUITMENT
CHAPTER 80:Rescue Therapy in ARDS: Prone Ventilation and High Frequency Oscillation Ventilation (HFOV)
- PRONE VENTILATION
- Methodology
- CONTRAINDICATIONS
CHAPTER 81:Extracorporeal Membrane Oxygenation
- INTRODUCTION
- EXCLUSION CRITERIA FOR NEONATAL ECMO
- TYPES OF ECMO
- Indications of Adult ECMO
- Contraindications
- STARTING ECMO
- CESAR Trial
- PARTIAL ECMO SUPPORT— EXTRACORPOREAL CO2 REMOVAL
- NOVALUNG INTERVENTIONAL LUNG ASSIST (AV PUMP-LESS ECMO)
CHAPTER 82:Aerosol Delivery Systems in Mechanical Ventilation
- THE MECHANISM OF AEROSOL DELIVERY
- AEROSOL THERAPY DURING MECHANICAL VENTILATION
- SPACER OR ADAPTER DEVICES (Figs. 1A and B)
- AEROSOL DELIVERY SYSTEMS
  - Jet Nebulizers
  - Ultrasonic Nebulizers (Figs. 2A and B)
- AEROSOL DEVICE: VIBRATING PLATES (Figs. 3 TO 5)
- AERO PROBE (FIG. 6)
- PULMONARY DRUG DELIVERY SYSTEMS (FIGS. 7 AND 8)
- Technique for Drug Delivery by MDI in Ventilated Patients (Fig. 9)
- Technique for Drug Delivery by Jet Nebulizer in Ventilated Patients
- SIGNIFICANT DIFFERENCE IN HUMIDIFIERS VERSUS NON-HUMIDIFIERS AEROSOL DELIVERY DURING NONINVASIVE VENTILATION
APPENDIX 1:Appendix 1: Hemodynamic Formulae and Values
- Cardiac Output
- Normal Hemodynamic Parameters: Equations and Normal Range
APPENDIX 2:Respiratory Formulae and Values
- Fick's Equation for Oxygen Consumption
APPENDIX 3:Acid-Base Balance, Renal Formulae and Values
- Base Deficit
- Renal Equations
- Cockcroft and Gault
- Indices in Acute Renal Failure
- Urine Analysis in Different Conditions
APPENDIX 4:Scoring System Used in ICU
APPENDIX 5:Spectrum of Commonly Used Antibiotic in ICU

INDEX

TOC
Index

×

Chapter Notes